Prior Authorization and Insurance Verification Specialist

I was also in charge in obtaining prior authorization for all procedural orders like Diagnostic Imaging, Muskuloskeletal, Surgeries, injection, sleep study, oncology, J-codes, etc. from commercial payers like UHG, Aetna, Anthem, Cigna, BCBS, and more. The process of completing authorization includes eligibility, benefits and facility verification, reviewing patients charts, familiarity of medical codes and payer portals, peer to peer review and more.

I was a precertification coordinator for almost two years with AthenaHealth. I was responsible for day to day administrative tasks like patient scheduling, data entry, and answering patient inquiries via inbound and outbound calls as well as email management.